What Your ADHD Healing Might Be Missing: Metacognition
While healing is not linear, ADHD brains seem to have an especially hard time making progress. If you’ve been "doing the work” and still feel stuck, this one’s for you.
Scroll to the bottom for a TL;DR (too long; didn’t read) blurb :)
“K, but what does it mean to ‘do the work’? I’ve been ‘doing the work’ in therapy for years and I’m still struggling with the same sh*t”
A dear friend of mine—and fellow ADHDer—asked me this recently, her voice a mix of exasperated frustration and sincere curiosity, during one of our many dinner-table deep dives into trauma, growth, and what it actually means to heal. (You know, just your typical, light-hearted chat over shrimp stir-fry.)
We’d been talking about some of the recent progress I’d made with my self-worth and mental health and I mentioned how I felt like I was “doing the work,” when she stopped me with this question. Her words struck a chord in me as they hit on something deeply relatable that I believe goes beyond just the two of us, to a universal aspect of living with ADHD.
A spiral staircase without the stairs: why does it feel like we are just walking in circles?
Like my friend, I’ve spent years—and thousands of dollars—on therapy. I could explain my issues in exquisite detail, trace them all the way back to childhood, label them with DSM precision…and still find myself stuck in the same old loops.
I’d go to therapy, have a major insight, maybe even call a friend afterward to share this major insight, return to the chaos of my daily life, immediately forget said major insight, get pummelled by life, return to all my old habits, and then show back up in my therapist’s office a few weeks later to debrief the pummelling (and maybe even generate a new major insight to call a friend about).
To be fair, this loop isn’t entirely unique to ADHD. I once heard writer and podcaster Glennon Doyle describe healing as a spiral staircase: we revisit the same wounds again and again, ideally from a higher floor—each time a little wiser, a little stronger. But for many of us with ADHD, it feels like our staircase is missing stairs — leaving our healing journeys feeling more like we are walking around in a circle.
But that night, sitting across from my friend over our shrimp stir-fry, I realized what had finally changed for me — I’d found some stairs (in the form of a simple daily ritual).
The missing piece: metacognition
A few months ago, I signed up for a self-development app (yes, I admit it—I’m a self-help junkie). The program itself had some great teachings, but as I reflected on my friend's question (nay - plea), I realized a big part of my momentum had really come from the daily routine I had been doing to support my work in the program.
For the last few months, I’d started almost every morning with a ritual I’d come to cherish.
With my coffee in hand, I’d sit down and write out any challenges that had come up the day before. I’d connect those challenges to relevant insights (which I kept written down in front of me), identify next steps that aligned with those insights, review previous entries from earlier in the week, look for patterns, and track where I was—or wasn’t—taking action.
In just a few months, I had made more progress than I had in years of therapy alone*.
While therapy gave me insight, this practice gave me a way to use those insights and in turn, generate real progress in my life.
And here’s why: according to neuroscientist Anne-Laure Le Cunff, progress requires two key ingredients—trial and error. We try something, observe the results, and adjust. Without both, we don’t grow.
The tricky part? That second part—observe and adjust—requires something called metacognition. That’s the ability to think about your thinking, to know your own mind. And for ADHDers, that’s not automatic—it’s a skill we have to consciously build.
Dr. Sharon Saline, a leading ADHD psychologist, explains why its a skill worth building:
“Metacognitive thinking, along with self-regulation, helps you choose, monitor, and evaluate how you approach a task, measure progress, and how close you are to achieving (or not) your final goal; The ability for self-regulation and assessment (metacognition) allows you to achieve specific goals better, learn what worked well (and what didn’t), and then apply that learning to future tasks.”
Le Cunff puts it even more bluntly:
“Without this kind of reflection, we don’t pay enough attention to extrapolate our experience into the future. And the wheel of trial and error doesn’t lead to improvement.”
In other words:
Metacognition = Stairs
Stairs = Progress (AKA ‘doing the work’ and actually getting somewhere)
When your brain forgets its own breakthroughs
But as Dr. Saline notes, people with ADHD often need to bring intentional effort to build these metacognitive skills.
Why? Because in order to pause and reflect, you have to be able to… well, pause. And that’s something the ADHD brain struggles with. On top of that, we’re working with impaired working memory—a core executive function that allows us to temporarily hold and manipulate information. Think of it like your brain’s mental sticky note system. It helps you remember directions, keep track of what you’re doing mid-task, or recall an insight long enough to act on it. When working memory is impaired, those sticky notes fall off fast. Trying to remember why we just walked into the kitchen can look a lot like this:
Trying to remember a therapy insight from two Tuesdays ago WHILE dysregulated?
Forget it.
Literally.
I can’t count the number of times I experienced a breakthrough in my life, only to find myself slipping right back into the same old patterns. For years, my personal growth felt like playing a video game where I’d finally beat a level—only to forget how I did it. My family would celebrate with me after some huge realization…and a few weeks later, they’d watch in confusion as I slipped back into the same narrative, as if that breakthrough had never even happened.
Through talking it out and regaining my footing, we’d often manage to find the insight again—the key that had unlocked that level the first time. It was still there, somewhere in my mind. I just couldn’t access the knowing when I needed it most.
But then came this daily practice.
Our solution: distributed cognition (because the brain is for having ideas, not holding them)
By writing things down—my challenges, patterns, insights, and aligned actions—and revisiting them each day, I was unknowingly doing what ADHDers have to do to access what Anne-Laure Le Cunff calls the metacognitive edge: I externalized my brain.
This is the power of distributed cognition—leaning on tools outside our own minds to hold what we might otherwise forget. And when we do that, it doesn’t matter that our sticky notes aren’t as sticky as everyone else’s because we’re effectively stapling them to the wall.
Whether it’s a notebook, your phone, a whiteboard, or a pile of literal sticky notes, the key message is this: don’t rely on your sweet ADHD brain to do what it’s not built to do. As productivity expert David Allen puts it, “your mind is for having ideas, not holding them.”
This is how we turn our circle into a spiral staircase—by offloading what we’d otherwise forget, and coming back to it again and again (and again).
And if your brain likes sparkle, hates friction, and craves a ritual that feels just a bit more special—I’m working on something just for you.
✨ My Therapy Companion Tool will be available on my Etsy shop soon ✨
It’s a simple, ADHD-friendly journal system designed to help you do the work between therapy sessions.
Inside, you’ll find:
A “Things I Know” list to capture and revisit your insights
Space to name the shadow stories that get activated (see this post for more information on The ADHD Shadow)
A tracking system to reflect on what’s working (and what’s not)
A daily structure to review, reground, and re-remember
If you want to support my work and give your brain a beautifully designed boost, simply Comment “YES PLEASE” below and I’ll send you a 25% discount code when it goes live on Etsy!
TL;DR:
You can have all the therapy insights in the world, but if your ADHD brain can’t hold onto them or apply them in daily life, it can feel like you’re endlessly walking in circles. That was me—until I started a simple daily reflection ritual that helped me actually use what I was learning. The secret sauce? Metacognition—a skill ADHD brains need to consciously build. By writing things down, reviewing them often, and externalizing my thoughts, I finally created the “stairs” I needed to make real progress. If you’ve been “doing the work” but still feel stuck, you might just need a new way to hold onto your own breakthroughs. 💡✨P.S. I’m launching an ADHD-friendly journal to help you do exactly that—The Therapy Companion Tool. Comment “YES PLEASE” below and I’ll send you a 25% discount code when it goes live on Etsy!
*Quick note of transparency: Over the past few months, I’ve also been exploring a higher dosage of my ADHD medication. It’s likely played a role in boosting my motivation and executive function—maybe even helping me climb the stairs a bit more easily. But I can say with confidence it’s the practices I’ve shared in this post that actually built the stairs.
Yes please! Another VERY insightful article. Thank you Laura
Yes please!